Blogs, letters and media

While there’s occasionally talk of the potential impact of telemedicine on greenhouse gas emissions, there’s only been limited research.

We looked at the direct and indirect greenhouse gas emissions for almost 21,000 telemedicine consultations performed during 2004-11 in Alentejo, Portugal. The results were dramatic. Telemedicine may have led to a 95% reduction in distances travelled - or 2.3 million kms of travelling by patients - and a total of 455 tonnes of CO2 equivalent (22 kg per patient).

How we include such reductions in greenhouse gas emission needs to be considered when assessing the cost-benefits of remote care.

Research conducted by: Tiago Cravo Oliveira, James Barlow, Luis Gonçalves, Steffen Bayer (Imperial College London and Administração Regional de Saúde do Alentejo)

More evidence that the really innovative thinking in the remote care world is coming from lower income countries. Dr Sikder Zakir from the Telemedicine Reference Centre (TRC) in Bangladesh reported on the use of mHealth to improve access to underserved populations. Usually this would involve telemedicine – in its m- or non-mHealth guises – bringing healthcare to remotely located rural populations. Bangladesh is no exception, with 40,000 doctors and 25,000 nurses for 160 million people. But as is only too obvious to anyone who has been to countries in the Gulf there is a huge population of migrant workers living there. The 5 million expats from Bangladesh have 20 million dependents back home dependent on remittances, but neither side is well served for healthcare. The TRC is using mHealth to provide expats with access to doctors in Bangladesh via SMS messaging and voice calls, and extends the service – free – to up to five of their family members. Funding is via a $3 a month subscription paid via the migrant worker’s mobile phone network. The scheme is being tried out with 80,000 migrant workers in Singapore, before moving to Saudi Arabia and the UAE.

We also heard from Dr Zakir about AMCARE, an example of mHealth being used to extend diabetes care from hospitals to villages. This uses microinsurance payments (50 US cents / month) to cover the costs, a business model that is now gathering momentum in developing countries’ health systems.